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With every step forward, we seemed to take two steps back. Two important business groups―the Chamber of Commerce and the National Association of Manufacturers―

had told Ira in mid-1993 they could live with one key component of the bill, the employer mandate, which would require businesses with more than fifty employees to offer health insurance to their workforces. These business groups knew that most large employers already provided health insurance and concluded that the mandate would eliminate free riders who did not. By the end of March 1994, however, when a subcommittee of the House Ways and Means Committee voted 6-5 for the employer mandate, these two groups, pressured by Republicans and reform opponents, had flipped their positions.

The mandate was clearly controversial, and Bill began making concessions and compromises with Congress. Although he had threatened to veto any legislation that didn’t include universal coverage, he indicated that he could support something less. This was part of the natural give-and-take expected during legislative bargaining, and it opened the way for the Senate to consider a proposal, sponsored by members of the Finance Committee under Senator Moynihan, to cover 95 percent of all Americans instead of 100 percent. Even that concession didn’t produce significantly more allies. In fact, we lost support among some hard-liners who felt that by agreeing to anything less than 100

percent, we were deserting the cause.

In the spring, Dan Rostenkowski was indicted on seventeen counts of conspiring to defraud the government. We lost a key ally in the House as he eventually resigned and was convicted. This followed the disappointing news that Senate Majority Leader George Mitchell had decided not to run for reelection, which meant that the most powerful Democrat in the Senate and the champion of our bill was now, in effect, a lame duck.

We also found out that health care reform represented a steep learning curve for more than a few members of Congress. Given the volume of bills they are expected to vote on, most members focus on legislation related to their committee assignments and don’t have time to learn the intricacies of every issue before the House or Senate. But I was surprised to encounter more than one Congressman who didn’t know the difference between Medicare and Medicaid, both federally funded health insurance programs. Others had no idea what kind of health insurance coverage they received from the government. Newt Gingrich, who in 1995 would become Republican Speaker of the House, contended during an appearance on Meet the Press in 1994 that he didn’t have government health insurance but bought it from Blue Cross-Blue Shield. In fact, his policy was one of many offered to federal employees through the Federal Employees Health Benefits Plan. And the government covered 75 percent of the $400 monthly bill for Gingrich and other members of Congress.

This knowledge gap became apparent to me at a meeting I had in the Capitol one day with a group of Senators. Invited to answer questions about the Administration’s plan, I had distributed a briefing book summarizing what we proposed. Senator Ted Kennedy, one of the true experts on health care and many other issues in the Senate, was leaning back on two legs of his chair as he listened to question after question posed by his colleagues.

Finally, the front legs of his chair struck the floor and he barked out: “If you would just look on page thirty-four of the briefing material you’ll find the answer to that question.” He knew every detail―including page numbers―off the top of his head.

Even some of our allies in the advocacy community created problems. One of the most important organizations in the reform campaign was the American Association of Retired Persons, or AARE The powerful senior citizens’ lobby group began running its own ads in March 1994, insisting that Congress pass a health care reform bill that would require prescription coverage. The AARP was adamant about prescription drugs and so was I. Although the AARP intended to help us, the ad had a corrosive effect because it made people think that our plan did not contain a prescription drug provision―which, of course, it did.

I worked hard to keep the pro-reform forces together, under the umbrella of the Health Care Reform Project. But we could raise only about $15 million to run a public information campaign and to recruit speakers to fan out across the country. We were thoroughly outspent by our heavyweight corporate opponents who, according to estimates, infused at least $300 million into their campaign to defeat reform.

The insurance industry’s distortions were so effective that many Americans didn’t understand that key elements of reform―which they supported―were actually in the Clinton plan. One news story in The Wall Street Journal on March 10, 1994, summed up our dilemma under the headline MANY DON’T REALIZE IT’S THE CLINTON PLAN

THEY LIKE. The writer explained that while Americans strongly supported specific elements in the Clinton plan, “Mr. Clinton is losing the battle to define his own health care bill. In the cacophony of negative television ads and sniping by critics, foes are raising doubts about the Clinton plan faster than the President and Hillary Rodham Clinton can explain it. Unless the Clintons can cut through the confusion, the outlook for passage of major elements of their bill is in doubt.”

While Washington was caught up in health care reform and Whitewater, the rest of the world was not. In early May, the U.N. tightened sanctions on the military junta in Haiti, and a new wave of Haitian refugees headed to American shores. A crisis was building, and Bill felt he had to ask Al Gore to fill in for him on a trip to South Africa for Nelson Mandela’s presidential inauguration. Tipper and I joined Al as members of the U.S.

delegation. I was thrilled at the prospect of taking part in this momentous event. During the 1980s, I had supported the boycott of South Africa, hoping that the apartheid regime would bow to international pressure. On the day Mandela walked out of prison in February 1990, Bill woke Chelsea before dawn so together they could watch the drama unfold.

I traveled in a packed plane for the sixteen-hour flight to Johannesburg. My companions stayed up all night playing cards, listening to music and talking ecstatically about the historic change we were about to witness. After serving twenty-seven years in prison for plotting against South Africa’s apartheid government, Nelson Mandela had won that country’s first interracial election to become its first black President. The liberation struggle in South Africa was deeply linked with the American civil rights movement and supported by African American leaders, many of whom were coming with us to honor Mandela.

We landed on the outskirts of Johannesburg, a sprawling modern city in South Africa’s dry central highlands. That night we attended a performance at the famous Market Theatre, where for years Athol Fugard and other playwrights had defied government censors and depicted the agony of apartheid. Afterwards, we were treated to a buffet dinner featuring assorted African specialties along with the usual carved meats and salads. I wasn’t as adventurous as Maggie and the rest of my staff who dared one another to sample the fried grasshoppers and grubs.

Our delegation drove north to the capital, Pretoria. Because the official transition of power didn’t occur until the new President was sworn in, the President’s stately residence was still occupied by E W de Klerk. The next morning, while AI Gore met with de Klerk and his ministers, Tipper and I had breakfast with Mrs. Marike de Klerk and the wives of other outgoing National Party officials. We sat in a wood-paneled breakfast room thickly decorated with ruffled fabrics and porcelain knickknacks. A lazy Susan in the middle of a big round table was heaped with the jams, breads, biscuits and eggs of a classic Dutch farm breakfast. Although we made light conversation about food, children and the weather, the moment was subsumed in the unspoken subtext: in a few hours, the world these women inhabited would disappear forever.

Fifty thousand people attended the inauguration, a spectacle of celebration, release and vindication. Everyone marveled at the orderly transfer of power in a country that had been so ravaged by racist fear and hatred. Colin Powell, a member of our delegation, was moved to tears during the flyover of jets from the South African Defense Force. Their contrails streaked across the sky, tinted with the red, black, green, blue, white and gold colors of the new national flag. A few years earlier, the same jets were a powerful symbol of apartheid’s military power; now they were dipping their wings to honor their new black commander in chief.

Mandela’s speech denounced discrimination on the basis of race and gender, two profoundly embedded prejudices in Africa and most of the rest of the world. As we were leaving the ceremony, I saw the Rev. Jesse Jackson weeping with joy. He leaned over and said to me, “Did you ever think any of us would live to see this day?”

We returned by motorcade to the President’s residence to find it transformed. The long winding drive through green lawns, which just hours before had been lined with armed military men, was now arrayed with brightly costumed drummers and dancers from throughout South Africa. The mood was light and joyous, as if the air itself had changed in an afternoon. We were ushered into the house for cocktails and to mix and mingle with the dozens of visiting heads of state and their delegations. One of my challenges that afternoon was Fidel Castro. The State Department briefers had warned me that Castro wanted to meet me. They told me to avoid him at all costs, since we had no diplomatic relations with Cuba, not to mention a trade embargo.

“You can’t shake hands with him,” they told me. “You can’t talk to him.” Even if I accidentally bumped into him, the anti-Castro factions in Florida would go wild.

I frequently looked over my shoulder during the reception, watching for his bushy gray beard in the crowd of faces. In the middle of a fascinating conversation with somebody like King Mswati III of Swaziland, I’d suddenly spot Castro moving toward me, and I’d hightail it to a far corner of the room. It was ridiculous, but I knew that a single photograph, stray sentence or chance encounter could become news.

Lunch was served on the grounds under an enormous white canvas tent. Mandela rose to address his guests. I love listening to him speak in that slow, dignified manner that manages to be both formal and alive with good humor. He made the expected remarks to welcome us. Then he said something that left me in awe: While he was pleased to host so many dignitaries, he was most pleased to have in attendance three of his former jailers from Robben Island who had treated him with respect during his imprisonment. He asked them to stand so he could introduce them to the crowd.

His generosity of spirit was inspiring and humbling. For months I had been preoccupied with the hostility in Washington and the meanspirited attacks connected to Whitewater, Vince Foster and the travel office. But here was Mandela, honoring three men who had held him prisoner.

When I got to know Mandela better, he explained that as a young man he had a quick temper. In prison he learned to control his emotions in order to survive. His years in jail had given him the time and motivation to look deeply into his own heart and to deal with the pain he found. He reminded me that gratitude and forgiveness, which often result from pain and suffering, require tremendous discipline. The day his imprisonment ended, he told me, “as I walked out the door toward the gate that would lead to my freedom, I knew if I didn’t leave my bitterness and hatred behind, I’d still be in prison.”

Still pondering Mandela’s example the night I returned from South Africa, I joined five former First Ladies at the National Garden Gala. I was the honorary Chair of the event at the U.S. Botanic Garden to help raise funds to construct a new garden that would be a living landmark on the Mall, dedicated to eight contemporary First Ladies and honoring our contributions to the nation.

I was delighted that Lady Bird Johnson was able to attend. She and I wrote each other during my years in the White House, and she was a comforting and affirming correspondent.

I admired the quiet strength and grace she had brought to her position as First Lady.

She began a beautification program that spread wildflowers along thousands of miles of U.S. highways and enhanced our appreciation of the natural landscape. Through Lady Bird’s advocacy, a generation of Americans learned new respect for the environment and were inspired to preserve it. She also championed Head Start, the early learning program for disadvantaged children. And when it came to campaigning, she barnstormed the South for her husband in his 1964 race against Barry Goldwater. Throughout a difficult time in the White House, she understood that presidential politics required commitment and sacrifice. With her intelligence and compassion, she held her own in a world dominated by Lyndon Johnson’s oversize personality Disheartened by Washington, I valued her hard-won sense of perspective.

The photos from that gala evening were keepers: Lady Bird, Barbara Bush, Nancy Reagan, Rosalynn Carter, Betty Ford and me. It was quite a sight: all the living First Ladies standing together onstage – except for one.

Some months earlier, Jackie Kennedy Onassis had been diagnosed with non-Hodgkin’s lymphoma, an often deadly but sometimes slow-moving cancer. As a result, she was unable to be with us. We’d been told that she had gone through surgery, but not how quickly she had weakened. True to character, she tried to keep her dying as private as she’d kept her life.

On May 19, 1994, Jackie died in her New York apartment, with Caroline, John and Maurice at her side. Early the following morning, Bill and I went to the Jacqueline Kennedy Garden off the east colonnade of the White House to share our thoughts with a gathering of press, staff and friends. Bill recognized her contributions to our country, while I talked about her selfless devotion to her children and grandchildren: “She once explained the importance of spending time with family and said: ‘If you bungle raising your children, I don’t think whatever else you do matters very much.’ “ I could not have agreed more. I attended her funeral mass in New York City at St. Ignatius Loyola Roman Catholic Church and then flew to Washington with her family and close friends. Bill met the plane at the airport and went with us to the grave where Jackie was buried beside President John E Kennedy, their infant son, Patrick, and an unnamed stillborn daughter.

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